PATRICK L SUPPAN Perfusionist License verification

Business Entity

ACTIVE

License Type

Perfusionist

Description

LICENSED PERFUSIONIST

License Number

214000130

License Status

ACTIVE

Business

First Name

PATRICK

Middle

Last Name

SUPPAN

Business Name

PATRICK L SUPPAN

Original Issue Date

02/14/2003

Effective Date

02/03/2024

Expiration Date

04/30/2026

City

MAKANDA

State

Zip

62958

County

JACKSON

Ever Disciplined

LastModifiedDate

02/03/2026